Spontaneous intracerebral hematoma: Which etiologies? And what predictions prognosis? A study about 253 patients

Abstract

Intra-cerebral hematoma (ICH) is a serious pathology, destructive for the parenchyma, whose mortality is very hight and had a reserved prognosis. The factors influencing the vital and functional prognosis are however poorly known and the decision to resuscitate or evacuate a hematoma is sometimes very delicate in the acute phase, We conducted a retrospective, descriptive and analytical study of 253 patients who presented spontaneous ICH collected at the Military Hospital of Tunis, over a period of 10 years. The first cause of HIC was hypertension (54.1%). The mean age of the patients was 62 years and the clinical manifestations were dominated by the motor deficit. Vascular malformations were the main secondary causes of ICH. Radiologically, the lobar seat of the hematomas was the most recurrent with varying volumes depending on the type of vascular malformation In terms of prognosis, the leading cause of death from all causes was septic shock (17.39%). The ICH score has also been applied in our population and it has been observed that the mortality rate increases in parallel with the ICH score. Complete functional recovery (Rankin <= 2) was seen in 29,2% of our patients whereas 70.8% had moderate to severe disability (Rankin> = 3). Contemporary with the aging of the population, the frequency of HIC is constantly increasing. Prognosis is generally less favorable than ischemic stroke with a high mortality rate. Thus acting on these factors associated with poor life and functional prognosis for better management.